An Idea Factory for Pathology Informatics and the Clinical Laboratory. Presented by the Pathology Education Consortium (PEC).

Web-Based Genomic Testing Sites Fail to Attract Large Paying Audience

Web-based genomic testing sites such as 23andMe and Navigenics have faced a number of barriers in order to attract clients including a high test price and a complex information product. It should therefore come as no surprise, as detailed by a recent article, that these companies have had difficulty in attracting paying customers (see: Consumers Slow to Embrace the Age of Genomics). Below is an excerpt from it:

Connected to Google by both love and money, 23andMe seems the epitome of a 21st-century company — a cutting-edge merging of biotechnology and the Internet, with a dash of celebrity thrown in. The scarce ingredient so far is customers. 23andMe is the most prominent of a trio of companies that in 2007 began using the Web to market personal genomics services. The companies scan people’s DNA, promising to tell them their risks of getting dozens of diseases. Propelled by its co-founder Anne Wojcicki, the wife of Google’s billionaire co-founder Sergey Brin, 23andMe attracted attention by holding swanky “spit parties” where people gave saliva samples for DNA analysis....But for the common consumer, 23andMe’s service — and those from its main competitors, Navigenics and DeCode Genetics — have been a much harder sell. Two and a half years after beginning its service, 23andMe has only 35,000 customers. And at least a quarter of them got the service free or for only $25, instead of the hundreds of dollars on which the business model is based. Navigenics and DeCode have even fewer customers. The low turnout suggests that many people have not yet embraced the genomics age — despite efforts by the companies to present genetics in an understandable and even entertaining way. It does not help, either, that the services cost $300 to $2,000 and have been trying to catch on during a severe recession. But the services face an even more fundamental problem: in most cases, the current level of DNA scanning technology and science is unable to offer meaningful predictions about the risk that a person will get a disease.

I have been a strong advocate for direct-access-testing (DAT) whereby consumers order and pay out-of-pocket for common lab tests on the web without a physician intermediary. Although the demographics of DAT customers are not widely available, I know that they generally skew toward an older and more affluent population. I suspect that many of them have health insurance so that their interest in monitoring their health is prompted, in part, by convenience factors. The cost of such testing is generally low and test result interpretation (e.g., cholesterol levels) is not particularly challenging.

It should come as no surprise that 23andMe has generated abundant media and venture capital attention given the identity of its co-founder and well as the continuing interest of the media in genomic testing (see: Celebrity Endorsement" of Genomic Testing on the Web). Clinical lab professionals are generally not accustomed to this much attention. I think that it's fair to say that the genomic testing industry has suffered as a result of this media hype and thus far been unable to deliver actionable test results that can justify the cost of testing for most clients. However, I think that it's time for all of us to take a deep breath and reduce our expectations. The science will soon catch up with its diagnostic potential. However, an interesting question to ponder is whether genomic testing will totally revert to hospitals and doctors' offices or whether there is a future for genomic testing sites on the web. After all, DAT itself continues as only a minor niche in the clinical lab industry as a whole.